Supply Request Form

Please fax, email or complete this form and submit it to the ACFT:

Fax: 403.270.2964
Email: acft.lab@ucalgary.ca
Form: download here for fax/email 
Clear: clears all values below

Fields marked with an asterisk (*) are mandatory.

 
If Government Courier is not available to the provided address, check this box.
Supply Select Unit QTY*
Requisition Form - Opioid Dependency Program Drug Testing
Urine Specimen Kit
For Samples Shipped to ACFT by Hospital Community Courier:
Bubble Envelope with McCaig Address Label
For Samples Shipped to ACFT by Purolator Courier:
Bubble Envelope with ACFT Address Label
Purolator Express Pack (Foil Envelope)
Purolator Pre-printed Bill of Lading (Waybill)
Supply Select Unit QTY*
Requisition Form - Non-Municipal Public Drinking Water System For Human Consumption
Requisition Form - Private Water Supplies Chemical Analysis For Human Consumption
Bottles (500 mL) with Matching Bags

Collection of personal information
Your personal information is collected under the authority of section 33(c) of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection or use of this information, please visit our Access to Information page.